SINUS PROBLEM

[NEWUSER91]

I have recently begun using a Bipap machine for complex sleep apnea diagnosed during a sleep study. I am using a Resmed S9 Bipap machine set at 10 and 6, with an H5i humidifier set at 6.0, a Resmed heated tube set at 83 degrees, a Fisher & Paykel Eson nasal mask and a Resmed chin strap. I have a history of sinus problems. I have had 2 operations to fix a deviated septum and increase air flow but with little success. I take benedryl and use a neti pot before bed. Sometimes I use a breathrite across my nose if I still have trouble breathing freely through my nose. Since using the Bipap machine I have also tried Nasonex which did not help and Flonase, which helped for a short time and then began producing headaches. I can breath normally while the machine is on but after using the Bipap for an hour my sinus becomes so stuffed that I can’t breath well enough to fall asleep for hours. After a few nights I am too exhausted to continue and stop using the Bipap until my sinus normalizes.
Does anyone have any ideas as to how I could use the Bipap machine and not worsen my sinus problems ?

Thank You

[Julie]

Curious as to how much you played with humidity settings - sometimes it can be too low (dry) but often too high, causing congestion for some people.

[Pugsy]

Have you tried reducing the humidifier setting from 6?
That's the maximum...some people do better in terms of congestion with less added humidity.

[HerbM]

Flonase has (probably) been working better for me too than Nasonex did.

+1 on humidity.

You might try a pillow or nasal prong mask -- this is primary different in term of keeping your external nose "inflated" too so not much need (according to my sleep doc) for the breathright strips. (I think they still help A LITTLE.)

(I love the Airfit P10 but nasal pillows have to work for you in general to use that mask.)

My wife also had the turbinate reduction but didn't see much improvement.

What about saline lavage? Does that make a difference?

(Recently, I have found and fallen in love with the NeilMed SinuGator, about ~US $25.)

[NEWUSER91]

I was told to start the humidity at 3.0 and slowly raise it until the sinus issues abated. I was doing alright for a while with the humidifier at 4.5 or 5.0 and using Flonase. Then I started to get headaches right after using the Flonase that got worse each day so I had to stop using it. I do not have trouble with my sinus while using the machine. After I stop my sinus feels swollen and not much air passes through. This lasts for days. After this I raised the humidifier to 5.5 then 6.0. No help.

I understand what you mean about too humid. In the summer I have to have the AC on enough to keep the humidity below a certain point or I have this same problem. I just do not know how to proceed from here.

What is saline lavage ?

I have been reading reviews of some of the Neilmed products on Amazon and have ordered some. They seem to work for a lot of people.

[HerbM]

Sorry to be unclear, "saline (nasal) lavage" is a polite way of saying "snort salt water through you nose."

First though, you do need to Google and get the recipe for "isotonic saline" which is basically about as salty as body fluids and does NOT BURN -- water burns, heavy salt water burns but the right solution does not. (You add a little backing soda and this buffers it and makes it a little better too.)

The solution should be quite warm, but not hot.

You can do lavage a number of ways and some take NO special equipment. Neti pots are popular but I would just as soon put a regular cup on my upper lip and drink or snort the saline through my nose.

You drink it much like you would a cup of tea, sniffing or snorting as needed to clear it through (and spit).

NeilMed devices come with little pre-mixed packets to make up the saline correctly but my wife and I save those for travel -- they are only about 100 times more expensive than making your own. Convenient but not necessary either.

The NeilMed bottle is just a really convenient way to squeeze the salt water into your nose -- the pickup tube goes to the bottom so that you can squeeze the bottle while it is pointing up (into your nose) rather than having to turn it over to avoid air.

The NeilMed SinuGator is the best method (I have so far found) but remember the simplest requires NO SPECIAL EQUIPMENT -- just salt, water, and a cup.

When I was diving, I used to do it with sea water and scoop it up with my hand before putting on my helmet to descend. (Sea water is pretty close.)

One such recipe:
1 teaspoon of pickling/canning salt (don't use table salt because it contains a number of additives)
1 teaspoon baking soda (not baking powder)
1 pint of warm water (not hot).

I do use table salt with no ill effects; and we don't usually put nearly that much baking soda into the mix.

Also we mix up the dry materials ahead of time in a small plastic (e.g., Tupperware) container and keep it in the bathroom with a small measuring spoon (but it isn't hard to just guestimate the amount with A LITTLE practice.)

Usually we use half the measures above: an 8 oz or 1 CUP with 1/2 tsp salt etc.. in the cup, and run very warm but NOT HOT water and stir.

[desmondwl]

At one time I had sinus problems. Because of these I use a fullface mask. I just slightly part my lips so the pressure can enter orally. Almost 18 months ago I had pollops removed from my left nostril. This cleared my breathing problems through my nose and made a definite difference. I still use a fullface mask because I'm so used to it. Besides, can't complain too much with and AHI of 1.8.

[Julie]

Try a lower humidity setting for a few nights and see if things improve.

[sleeplessinaz]

I agree that you should turn down that humidity. I use mine on 4.5 but I live in the desert.
Some people get more stuffy the more humid it is - turn it down to a 1 or 2 and see how that goes.